New model of urgent dental care helps patients in North East and North Cumbria

North East and North Cumbria Integrated Care Board (ICB) launched UDACs in Darlington and Carlisle in June and September 2024, respectively, to increase the provision of urgent and emergency dental care in the region.

The pilot is part of the ICB's measures to protect, retain and stabilise local dental practices and dental care in response to significant local and national challenges for NHS dentistry, including general dental routine access, workforce recruitment and retention, and financial and regulatory issues.

Each UDAC offers 30-minute appointments with the aim of diagnosing and treating issues in one session. There are 28 urgent care appointments available at each surgery every day – offering a combined total of over 14,000 additional urgent care appointments per year.

Patients can access appointments for urgent and emergency needs via online booking or referral from NHS 111.

Since its launch, Carlisle UDAC, run by CumbriaHealth, has treated almost 1,800 patients who were unable to access a local NHS dentist in Cumbria when they experienced an urgent or emergency dental issue.

Shiv Pabary, Dental Clinical Advisor at NHS England Cumbria and the North East, said: "Many of the patients who have attended the Carlisle UDAC have high needs as they have been unable to access care since the Covid-19 pandemic. Once CumbriaHealth has addressed the patient's urgent problem, it often gives the option of returning to the centre to have follow-on stabilisation treatment with a dentist or therapist to avoid further urgent dental care re-attendance.

"The UDAC provides a valuable service and safety net for those patients with an urgent need who have been unable to reliably access high-street NHS dental care."

Feedback from the pilot scheme is positive. Darlington UDAC has delivered above its commissioned capacity (treating over 4,000 patients to date) and 96.4% of patients received definitive treatment for their presenting urgent dental care problem. Research by Healthwatch found that some patients at Darlington UDAC had not seen a dentist in over ten years and many see it as a vital service to get the dental care they need.

One patient received a course of treatment at Darlington UDAC when he experienced acute dental pain: "I had a series of appointments at the centre over a few weeks. I was first referred by NHS 111 and received a filling, and I then booked follow-up appointments that resulted in medication for an infection and a tooth extraction.

"I've had guidance from the UDAC team about caring for the site of the tooth extraction and now seem to be pretty much pain and discomfort free. I'm so grateful for the team's help, care and advice throughout my treatment."

The ICB took on responsibility for commissioning dental services in 2023 and it's made steady progress in supporting the provision of reliable dental care in its communities. Alongside the UDAC pilot, the ICB is commissioning additional appointments from dental practices as well as additional out of hours treatment capacity. It has increased the rate paid to dentists to deliver NHS dentistry and is making available further funding to support practices that are at risk of handing back their NHS contracts. The ICB is also working with the deanery to support initiatives to stabilise and grow the dental workforce and continues to collaborate with local providers and partners to help children and vulnerable adults maintain good oral health.

David Gallagher, Chief Contracting and Procurement Officer at the ICB, said: "The UDACs in Darlington and Carlisle have allowed us to establish a robust, unscheduled urgent care solution that will provide an additional 14,000 urgent care appointments in our region every year.

"The pilot has shown that the UDAC model not only alleviates pressure from in-hours urgent care capacity across the system but ensures those in the greatest clinical need can access urgent and emergency dental care locally."

Following the success of the UDAC pilot, North East and North Cumbria ICB has approved plans to roll-out UDACs across the region.